The support of a nation and its government speaks volumes to soldiers who fight for them. Historically soldiers have paid any price and endured any pain to ensure the positive outcome of a conflict or war. Soldiers who fight for their government are not always greeted with open arms upon their return. Some are even shunned. In the most tragic cases, a once healthy eighteen year old boy, inflicted with a curable bullet wound, dies because of the lack of care in a Veteran’s Hospital. This is a travesty that will hopefully never be repeated.
Upon returning from
…after almost a year recovering from my wounds, I recall a smoldering cynicism and a sense of almost complete alienation from the people of my own homeland; there seemed to be more enemies here than there had been in Vietnam. (Kelley)
He was not one of the soldiers that got spit on when he returned, however he was never regarded as a war hero or even congratulated on making it home safely. He was simply ignored and forgotten about. No one dared to discuss the war with him. No one commented on his valiant behavior that led him to a safe return. No one even said, “Thank You.”
It is unfortunate that a society can be so cold and unfeeling to someone who has paid such a severe price. After the pains he has endured, he deserves more than a cold shoulder. Stories like Mike’s are plenty. Consider also another Vietnam Veteran, Bill Purdin, who said, “To this day I still expect rooms to explode. I still expect sudden violence. I learned to get along and to prosper, but I still can’t ride on a boat without distant thoughts and still can’t look around without a sense of worry, still concerned with ambush.” (Purdin) Bill is another brave man who never had the opportunity to heal properly from his tour of duty, due mainly to the significant lack of support. He continues, “I’ll never know who came home after me and who did not. I’ve been to the Wall four times and will go again, looking for names, feeling the letters cut in there; finding some, not finding others. And then there are those names I can’t remember.”(Purdin) Bill returns to the Wall with dreams of finalizing a vicious time in his past, a time that he would sooner forget, but cannot.
It’s unfair that they have not been given adequate assistance and support to deal with the mayhem that they endured by doing the country’s fighting. The only thing they have is a wall that wasn’t even constructed until 1982, nine years after the war was over.
Support for the Vietnam Veterans has increased substantially and there is much more support that is still needed. One facet of support that is infrequently broached is the conditions in the Veterans Administration Hospitals in which wounded veterans were being taken care of. The scene is appalling. Many reports claim a gross display of neglect and a significant lack of supplies. The staff is far too few for the overload of patients and it reflects in the poor care that the patients receive. Pat Christensen, the wife of a Vietnam Veteran speaks about the conditions,
‘… the attitude of some of the practical nurses was shocking. Some of the patients were forced to beg for food and water’… Instead of helping her husband go to the bathroom, she said, ‘they would put a towel under his hips and tell him to use the towel.’ (“Some VA Hospitals in Shocking Shape”)
In addition to that claim there are many patients who repeatedly called for pain controlling medication that never got delivered, sometimes because of the inattentive staff and other times because of the lack of supplies. Many patients were suffering from dehydration and severe malnutrition and were begging the staff for food and water. In some cases, the neglect even went so far as patients sitting in feces and urine for hours and sometimes days. Infections raged out of control and contagious diseases spread rapidly. Many reports claim that there were countless lives lost because of the lack of attentiveness and the unskilled and ill-equipped staff.
One report, done by a hidden-camera investigation provided by ABC News, states the following,
At a hospital near
At a neighboring facility, examining tables had dried blood and medications still on them. In several areas, open bio-hazardous waste cans were spilling over. Primetime obtained internal memos documenting that the equipment used to sterilize surgical instruments had broken down - causing surgical delays and possible infection risks.
With 130,000 young American men and women putting their lives at risk in
Most of the equipment that was in use was outdated and unstable, in some cases dangerously so. Sanitation is a main concern for hospitals and they had needle containers overflowing and bio-hazard containers that were scarcely emptied, this causes very serious concerns. The sterilization equipment was broken, increasing the spread of infections and diseases. Used linens can be crawling with infectious waste and can cause severe complications where none should exist. The ABC News report also brings up the issue of complications.
In 1999, Jack Christensen, a former army sergeant who served in the Korean War, was admitted to the VA hospital in
Complications can have more serious affects than the original disease or ailment. Such was the case for Jack Christensen. Had his pneumonia been treated properly and quickly he would perhaps still be alive today. Thousands of patients are admitted to hospitals every year with pneumonia and the fatality rate is exceptionally low. In most cases this can be treated within a matter of weeks and rarely takes more than two months.
Medical records were poorly updated and rarely transferred from one hospital to another when a patient was moved. In some of the worst cases, medical records were not even kept, or were lost because of a breakdown in organization. These are just some of the horrendous conditions that the Veterans Administration Hospitals had succumbed to.
In addition to the hospitals being laden with problems, many of the medical onsite installations, used for treating wounded personnel in
If a soldier needed a checkup or another visit to the hospital it could be seven months before an appointment could be scheduled, and in rare cases it took up to two years. Reports also indicate once a patient was admitted to the hospital the condition often worsened. Complicated by severe infections and multiple bed sores, some patients even required limb amputations or even died as a result of being in the hospital.
To accommodate the growing number of patients many VA Hospitals allowed residents, doctors not fully trained or qualified, to see patients also. This proved to be disastrous because the residents were not certified and did not have the knowledge to competently treat or even diagnose their patients. Nursing staff were assigned to three times their normal work load. Patients were only getting checked once a day, and sometimes not for several days.
IVs ran out, patients were neglected and dressings weren't changed… the staff was often idle and it would often take hours to get help. Other families said that if patients or their families persisted in asking for help, some of the staff retaliated. (“Some VA Hospitals in Shocking Shape”)
Another similar story was that of Terry Soles, a Vietnam Veteran who served in the Navy.
…he was one casualty of this practice. In 1998, he went to the VA hospital in Cleveland complaining of pain and diarrhea, and doctors removed small cancerous growths from his stomach and esophagus.
But as his symptoms persisted over the next two years, his wife says the VA gave him painful tests and repeatedly lost the results. His wife says Soles was seen by a parade of constantly rotating resident doctors, and there was little consistency in his care.
Once, Soles was prepped for surgery but before the operation the doctors who were present couldn't agree on what they were going to do, she said.
Before he got sick, the 6-foot Soles weighed more than 200 pounds. By the time his family finally decided to take him to a private hospital, he weighed 80 pounds. Some VA doctors thought his problem was psychosomatic.
When he could no longer recognize his own son, Soles was rushed to a private hospital. There, Soles learned he was "a total mass of cancer from his trachea to his renal bowel. And that there was nothing that could be done," his wife says. Terry Soles died three days later. (“Some VA Hospitals in Shocking Shape”)
This is a death that could have easily been avoided with proper treatment and a medical staff that was properly trained. A registered nurse, Sankey Williams, comments about the time period and prevention.
…Much of what was known about good medical care was not being used. I was providing care to people whose problems were avoidable. (Williams 305-6)
The use of knowledge is a very powerful thing when coupled with medicine. It allows the past to remain the in the past and allows our fervent study of medicine to progress. This progression is necessary because it allows scientists to focus on advancement rather than duplicating work that is already complete.
The drought of decent care lasted decades. It began during the Vietnam Conflict and ended recently with the introduction of many accreditations and new qualifications that every VA Hospital must subject themselves to. The most noteworthy accreditation was provided by JCAHO (Joint Commission on Accreditation of Healthcare Organizations).
JCAHO was established in 1910 by Ernest Codman, M.D. who envisions the end result being a system that operates on standardization. This would allow and even require hospitals to monitor and follow up with patients to determine if the course of treatment was effective. If it was effective, no further follow-up was required, however; if the treatment was not successful, there would be more testing and a different solution attempted until they were successful. This allowed significant superiority in treating patients and removed some of the guesswork from possible treatments by relating to a previous case that was similar. This system is still in place today although much advancement has been made since. By 1950 more than 3,200 hospitals are following these guidelines and by 1965 the Social Security Administration acknowledges that the requirements are in compliance with the standards for Medicare and Medicaid programs. This begins the chain of events that eventually lead to the entire VA Hospital network being unified.
The VA Hospitals began certification between 1989 and 1994. Soon to follow were many new policies that brought about dramatic changes in the VA Hospitals. Under the accreditation of JCAHO there were many transformations. Some medical facilities that could not meet the standards were forced to close. Guidelines that JCAHO put in place assisted the facilities in becoming more efficient. The patient outcome was also greatly enhanced.
Responding to these dire circumstances, the VHA began to create programs aimed at improving the standard of care throughout the system. For example, in the light of concern about poor surgical outcomes, the VHA designed sophisticated programs to collect prospective data on major surgical procedures and generate risk-adjusted outcome statistics to be distributed throughout the system. (Fihn 1963-65)
One of the many affects that the JCAHO certification had was the tracking of patients. It also prompted the Veterans Administration to create an advanced system that allowed doctors in any VA Hospital to know immediately what treatments had commenced, what prescriptions a patient was on and how long either was taking place. This is a monumental step toward better healthcare for our veterans, but is still just a step. There is a long way to go before the system will be streamlined enough to thwart criticism among the masses.
Today, the VA Hospitals are among some of the best hospitals in the nation. They have a higher patient satisfaction and more advanced technology than most hospitals in the private sector.
The veterans of today are feeling the affects of the struggle that has consumed the entire VA Hospital organization for the last ten or more years. They are reporting better healthcare than the national average.
Patients from the VHA scored significantly higher for adjusted overall quality (67% vs. 51%; difference, 16 percentage points), chronic disease care (72% vs. 59%; difference, 13 percentage points), and preventive care (64% vs. 44%; difference, 20 percentage points) (Williams 305-6)
By these figures, the VA Hospital is better in all three categories than the local private sector hospitals. There is, of course, room for improvement, but there always will be. JCAHO and other organizations are only asking to prevent the preventable and strive to be better.
The Veterans Administration is far from perfect, however; they continuously strive for better outcomes. The changes are not going unnoticed either; consider this statement from Ralph Wetzel, a chaplain of a VA Hospital with nine years tenor.
… I personally have seen continued improvements in patient care, medical equipment, the buildings in general, and I have talked to many veterans about our VAMC. Most have only praise for our quality care. (Wetzel)
Works Cited
Adams, John; Asch, Steven M.; DeCristofaro, Alison; Hicks, Jennifer; Keesey, Joan; Kerr, Eve
A.; Elizabeth A. McGlynn. “The Quality of Health Care Delivered to Adults in the
Erskine, Hazel. “The Polls: Pacifism and the Generation Gap” Opinion Quarterly
Winter72-Winter73:616-628
Fihn, Stephan D. “Does VA Health Care Measure Up?”
(2000): 1963-65
Hautala, Richard E. and Robert O. Muller. “
2000. AmericanRadioWorks 25 Sept 2006
radio.org/features/vietnam/scrapbook/entries/>
Hunt, Bill. “How
DeAnza.com. De Anza College.
swensson/interview_hunt_cominghome.html>
Joint Commission on Accreditation of Healthcare Organizations: Setting the Standard for
Quality in Health Care. joint_commission_history.htm> Kelley, Mike. “Coming Home” VietVet.org 1998 Moore, Purdin, Bill. “Landing on the Moon” LegendInc.com < http://www.legendinc.com/Pages/ ArchivesCentral/COTDArchives/MoonLanding.html> “Some VA Hospitals in Shocking Shape” ABCNews.com Works Cited (cont.) Wetzel, Ralph Merrill. “What Happened to VA Health Care?” Daily Nightly: MSNBC Williams, Sankey V. “Improving Patient Care Can Set Your Brain on Fire” Annals of Internal Medicine 143 (2005): 305-6
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